Strategy
In response to low kindergarten coverage of school required vaccines, the DC Department of Health (DC Health), the Office of the State Superintendent of Education (OSSE), and school partners launched a comprehensive, multiagency strategy to boost pediatric immunization rates with a strong emphasis on improving immunization compliance in schools.
Challenge
In 2020, the District of Columbia ranked last in the nation for kindergarten coverage of school-required vaccines, with only 78.9% of students receiving the recommended two doses of MMR. Like much of the country, DC experienced significant declines in routine pediatric immunizations during the COVID-19 pandemic, particularly from 2020-2021.
Solution
In order to address this gap, DC Health modernized data exchange pathways, expanded automated reporting, and improved the accuracy and completeness of student immunization records. A key driver of the progress of their efforts has been DC Health’s investment in strengthening data connections between health care providers, pharmacies, schools, and the District of Columbia Immunization Information System (DOCIIS). The Public Health Infrastructure Grant (PHIG) funded improvements to data infrastructure directly strengthened DC’s ability to protect children from measles. By ensuring that immunization data was complete, timely, and actionable, the District was able to close gaps more efficiently and drive the significant rise in MMR coverage observed over the past several years.
Outcome:
Strengthening data connections and collaborations with key school partners has produced substantial progress. Comparing School Year (SY) 2020–2021 to SY 2025–2026, MMR coverage among DC kindergarteners increased from 78.9% to 94.4%, a remarkable 15.5% improvement. Even compared to the previous school year, DC achieved an additional 1.7% increase, bringing DC much closer to the 95% coverage threshold needed to prevent measles outbreaks.
These upgrades dramatically reduced the number of missing or incomplete records, which are known barriers to understanding true vaccination coverage. As data quality improved, schools and public health teams gained a clearer, real‑time view of which students were overdue for MMR vaccination. This allowed for more targeted outreach like need-based letters and greater technical assistance to individual schools, earlier interventions, and faster follow-up with families.
Supplemental Materials